Abstract 33: Predictors of readmission and in-hospital mortality for patients admitted with multiple myeloma: Analysis of the nationwide readmissions database
Authors: Omid Yazdanpanah, Irfan Shafi, Jeffrey A. Zonder
Journal: Cancer Research (2022)

Abstract Background: Multiple Myeloma (MM) accounts for 17 percent of hematologic malignancies. Overall prognosis for MM has improved significantly in recent decades. However, patients with MM are at risk of recurrent hospitalizations that are expensive for healthcare systems and are considered as a factor in quality-of-care indices. Nevertheless, studies on predictive factors for hospital readmissions and mortality in patients with MM are limited. Understanding these factors can expedite development of strategies to reduce readmission, healthcare costs, and mortality. Methods: Utilizing the Nationwide Readmissions Database (NRD), we conducted a retrospective cohort study on patients admitted with MM between 2016 and 2018 across the United States. We used multivariable logistic regression to determine the predictors of unplanned readmissions within 30 days and mortality. Results: Of 20,362 patients hospitalized with MM, 25.5% were readmitted within the next 30 days. Mean length of stay was 10 days (95% CI 10.40-10.70). Total charge for index hospitalization was $ 120630 (95% CI 118456-122803.9). Predictors of early readmission included tumor lysis syndrome (P&amp;lt;0.01; OR 1.32, 95% CI 1.07-1.64), chronic kidney disease (P&amp;lt;0.01; OR 1.20, 95% CI 1.12-1.28), and diabetes mellitus (P&amp;lt;0.01; OR 1.10, 95% CI 1.02-1.19). In-hospital mortality for patients with MM was 6.54%. The predictors of inpatient mortality (Table 1) were sepsis (P&amp;lt;0.01; OR 6.00, 95% CI 5.17-6.97), disseminated intravascular coagulation (P&amp;lt;0.01; OR 4.05, 95% CI 2.64-6.21), acute stroke (P&amp;lt;0.01; OR 2.32, 95% CI 1.32-4.09), and pulmonary embolism (P&amp;lt;0.01; OR 2.16, 95% CI 1.40-3.35). Conclusions: One in four patients admitted with MM was readmitted to the hospital within 30 days. These hospitalizations were lengthy and costly for the healthcare system. Infection, bleeding, and thromboembolic events were the leading predictors of mortality during hospital stays. Table 1. Multivariate predictors of in-hospital mortality for patients admitted with MM Predictors Odds Ratio P value 95% CI Sepsis 6.00 &amp;lt;0.01 5.17 - 6.97 Disseminated Intravascular Coagulation 4.05 &amp;lt;0.01 2.64 - 6.21 Failure to Thrive 2.86 &amp;lt;0.01 2.37 - 3.45 CMV Infection 2.75 &amp;lt;0.01 1.24 - 6.10 Acute Stroke 2.32 &amp;lt;0.01 1.32 - 4.09 Pulmonary Embolism 2.16 &amp;lt;0.01 1.40 - 3.35 Acute Kidney Injury 1.78 &amp;lt;0.01 1.57 - 2.02 Bleeding 1.73 &amp;lt;0.01 1.43 - 2.09 Congestive Heart Failure 1.71 &amp;lt;0.01 1.48 - 1.97 Tumor Lysis Syndrome 1.68 &amp;lt;0.01 1.28 - 2.22 Invasive fungal infection 1.65 &amp;lt;0.01 1.31 - 2.07 Atrial Fibrillation 1.59 &amp;lt;0.01 1.36 - 1.86 Chronic Obstructive Pulmonary Disease 1.29 0.02 1.05 - 1.58 Charlson Comorbidity Index &amp;gt; 3 1.26 &amp;lt;0.01 1.10 - 1.45 Citation Format: Omid Yazdanpanah, Irfan Shafi, Jeffrey A. Zonder. Predictors of readmission and in-hospital mortality for patients admitted with multiple myeloma: Analysis of the nationwide readmissions database [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 33.